Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma

Screen exposure, mental health and emotional well-being in the adolescent population: is it time for governments to take action

During the last decade, a multitude of epidemiological studies with different designs have been published assessing the association between the use of digital media and psychological well-being, including the incidence of mental disorders and suicidal behaviours. Particularly, available research has very often focused on smartphone use in teenagers, with highly addictive potential, coining the term 'problematic smartphone use' and developing specific scales to measure the addictive or problematic use of smartphones. Available studies, despite some methodological limitations and gaps in knowledge, suggest that higher screen time is associated with impaired psychological well-being, lower self-esteem, higher levels of body dissatisfaction, higher incidence of eating disorders, poorer sleeping outcomes and higher odds of depressive symptoms in adolescents. Moreover, a significant association has also been found between screen time and higher suicide risk. Finally, problematic pornography has been shown to be highly prevalent and it is a strong cause of concern to many public health departments and national governments because it might be eventually associated with aggressive sexual behaviours.

Internet use and its association with physical activity among adolescents in Beni Municipality, Myagdi, Nepal

INTRODUCTION

Adolescence is a critical phase marked by distinct health and developmental needs and rights. It represents a pivotal time for the acquisition of knowledge, skills, emotional regulations, and relationship management. However, a recent surge in internet usage among adolescents has been observed, leading to a concerning decline in physical activity. This study aims to evaluate the level of physical activity and its correlation with internet use among adolescents.

MATERIALS AND METHODS

A cross-sectional study, conducted within educational institutions in Beni, Nepal, utilized a self-structured questionnaire to collect data on physical activity levels and associated factors. The relationship between physical activity and independent variables was assessed through the chi-square test, and regression analysis was employed to quantify the strength of this association.

RESULTS

The study revealed that 75.3% of adolescents (out of 385) exhibited inadequate physical activity levels. Notably, late adolescents were more susceptible to insufficient physical activity than their middle adolescent counterparts were. Adolescents from nuclear families (UOR = 2.689, C.I = 4.074-22.822), those with higher monthly family income (UOR = 3.318, C.I = 1.209-9.105), and individuals using Wi-Fi (UOR = 1.801, C.I = 1.117-2.904) demonstrated a higher likelihood of internet addiction. Moreover, these groups were more prone to engage in inadequate physical activity (UOR = 1.1740, C.I = 0.938-3.226) compared to their counterparts not addicted to the internet.

CONCLUSION

The study concludes that over two-thirds of adolescents were addicted to the Internet, and three-fourths were inadequately physically active, with late adolescents being more affected than middle adolescents. Inadequate physical activity was associated with various factors, including family type, monthly family income, monthly pocket money, father's occupation, type of school, type of internet access, and Internet Addiction Test (IAT) score. Internet-addicted adolescents were found to be more likely to be physically inactive.

Smartphone Addiction and Related Factors among Athletes

Smartphone addiction (SA) is increasing worldwide. The aim of this study is to determine the level of SA in athletes affiliated to the Turkish Handball Federation in Izmir and to examine its relationship with factors such as sociodemographic status, health status, eating attitude, and body perception. This cross-sectional study was conducted in March-April 2021 in Izmir Province. The sample of the study consisted of 212 licensed handball athletes. The short SA scale, three-factor nutrition scale, and body perception scale were used. A chi-square test was used for bivariate comparisons and logistic regression analysis was used for multivariate comparisons. The study was completed with 202 individuals (the coverage rate was 95.3%). The prevalence of SA was found to be 27.7%. The risk of SA increased 2.49-fold (CI: 1.17-5.31, p = 0.018) in female participants, 2.01-fold (CI: 1.01-4.06, p = 0.048) in participants with alcohol use, 2.17-fold (CI: 1.04-4.58, p = 0.042) in participants with low nutritional scores, 2.65-fold (CI: 1.15-6.10, p = 0.022) in individuals with high-income status, and 2.66-fold (CI: 1.07-6.64, p = 0.036) in individuals with high body perception scale score. In total, 27.7% of the athlete sample had scores above the SA threshold. These results point out that a behavioral addiction such as SA can occur even in professionals of an activity such as sports, known for beneficial effects in terms of healthy life.

Enhancing Behavioural Changes: A Narrative Review on the Effectiveness of a Multifactorial APP-Based Intervention Integrating Physical Activity

The rapid evolution of technologies is a key innovation in the organisation and management of physical activities (PA) and sports. The increase in benefits and opportunities related to the adoption of technologies for both the promotion of a healthy lifestyle and the management of chronic diseases is evident. In the field of telehealth, these devices provide personalised recommendations, workout monitoring and injury prevention. The study aimed to provide an overview of the landscape of technology application to PA organised to promote active lifestyles and improve chronic disease management. This review identified specific areas of focus for the selection of articles: the utilisation of mobile APPs and technological devices for enhancing weight loss, improving cardiovascular health, managing diabetes and cancer and preventing osteoporosis and cognitive decline. A multifactorial intervention delivered via mobile APPs, which integrates PA while managing diet or promoting social interaction, is unquestionably more effective than a singular intervention. The main finding related to promoting PA and a healthy lifestyle through app usage is associated with "behaviour change techniques". Even when individuals stop using the APP, they often maintain the structured or suggested lifestyle habits initially provided by the APP. Various concerns regarding the excessive use of APPs need to be addressed.

Weight stigma is associated with body mass index among college students in Taiwan: the mediated role of internalized weight stigma

BACKGROUND

Weight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies.

METHODS

This study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale - 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes' Process Macro was used to test a mediation model.

RESULTS

The changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup.

CONCLUSION

Because perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions.

A phubbing scale tested in Bangladesh, Iran, and Pakistan: confirmatory factor, network, and Rasch analyses

BACKGROUND

Phubbing, a phenomenon of ignoring others in face-to-face conversations due to mobile phone use, can be assessed using a Phubbing Scale (PS). Recently, the PS has been shortened into an eight-item version, the PS-8. However, psychometric properties of the PS-8 among Iranian, Bangladeshi and Pakistani individuals remain understudied, especially using advanced psychometric testing, such as Rasch and network analyses.

METHODS

Participants residing in Iran, Bangladesh, and Pakistan (n = 1902; 50.4% females; mean age = 26.3 years) completed the PS-8 and the Internet Disorder Scale-Short Form (IDS9-SF) via an online survey. Network analysis was used to examine if PS-8 items were differentiated from IDS9-SF items; confirmatory factor analysis (CFA) was used to examine the factor structure and measurement invariance of the PS-8; Rasch modeling was used to examine the dimensionality of the PS-8 and differential item functioning (DIF).

RESULTS

Network analysis showed that PS-8 items were clustered together with a distance to the IDS9-SF items. The CFA results supported a two-factor structure of the PS-8, and the two-factor structure was found to be invariant across countries and women and men. Rasch model results indicated that the two PS-8 subscales were both unidimensional and did not display DIF across countries and gender/sex.

CONCLUSION

The PS-8 is a feasible and robust instrument for healthcare providers, especially mental health professionals, to quickly assess and evaluate individuals' phubbing behaviors.

Nomophobia in university students during COVID-19 outbreak: a cross-sectional study

Introduction

Currently, access to the Internet through smartphones has led to their functions going beyond purely communicative ones, allowing the management of massive, instantaneous, and easily accessible information. This research analyzed the differences in smartphone use and the prevalence of nomophobia, mainly according to gender and university degree of Health Sciences students at the University of Zaragoza during the COVID-19 confinement in Spain.

Methods

A descriptive cross-sectional study was carried out on a sample of 318 first and second-grade students, who completed an online questionnaire sent to their institutional email, which included sociodemographic questions, other questions about smartphone use, and the Nomophobia Questionnaire (NMP-Q) scale.

Results

Compared to men (n = 58), women (n = 260) were more likely to use their smartphones more intensively daily, as were occupational therapy students compared to the other degree programs studied. The prevalence of nomophobia was moderate, being around the risk of suffering from it. No significant differences in scores for nomophobia among students were found according to gender, university degree, or population nucleus for the nomophobia scores of the students.

Discussion

The present study extends the existing literature on nomophobia by providing results of interest in terms of gender and the exceptional healthcare context of COVID-19. The results suggest that despite intense daily smartphone use young people did not reach severe nomophobia figures. This fact underlines the need for appropriate and healthy technology education. Understanding the characteristics of the populations that use the smartphone the most may help to analyze nomophobia rates and the massive use of the device.

Measurement Invariance and Psychometric Evaluation of the Tendency to Avoid Physical Activity and Sport Scale (TAPAS) Among Mainland Chinese University Students

Introduction

Preventative factors in young people's physical inactivity require further understanding, including related psychosocial factors (eg, body image and weight stigma). The Tendency to Avoid Physical Activity and Sport Scale (TAPAS) is a recently developed instrument to address this issue and the present study examined its psychometric properties among Chinese university students particularly in relation to patterns across sex, physical activity (PA) level, and weight status.

Methods

Using a convenience sample of 3142 students (mean age = 19.8 years; 56% female) in mainland China, data were collected using an online survey between August and October 2022. Psychometric instruments including the Weight Bias Internalization Scale, 21-item Depression, Anxiety and Stress Scale, and International Physical Activity Questionnaire Short Form were administered along with the TAPAS to assess convergent and discriminant validity. Multi-group confirmatory factor analysis (CFA) assessed the measurement invariance across specific groups.

Results

The unidimensional structure of the scale was confirmed through CFA (CFI=0.995; RMSEA=0.046). All configural, metric and scalar models of invariance indicated that the scale was invariant across sex, PA level, and weight status. Acceptable convergent and discriminant validity for the scale were found.

Conclusion

The TAPAS is a suitable instrument to assess body image and weight stigma concerns for avoiding physical activity and sport among Chinese university students.

Time Spent Outdoors and Associations with Sleep, Optimism, Happiness and Health before and during the COVID-19 Pandemic in Austria

Social restriction measures (SRM) implemented during the COVID-19 pandemic led to a reduction in time spent outdoors (TSO). The aim of this study was to describe TSO and evaluate its association with sleep outcomes, optimism, happiness and health-status before and during SRM. Two online surveys were conducted in 2017 (N = 1004) and 2020, during SRM (N = 1010), in samples representative of the age, sex and region of the Austrian population. Information on the duration of TSO, sleep, optimism, happiness and health-status was collected. Multivariable-adjusted logistic regression models were used to study the association of TSO with chronic insomnia, short sleep, late chronotype, optimism, happiness and self-rated health-status. The mean TSO was 3.6 h (SD: 2.18) in 2017 and 2.6 h (SD: 1.87) during times of SRM. Men and participants who were older, married or in a partnership and lived in a rural area reported longer TSO. Participants who spent less time outdoors were more likely to report short sleep or a late chronotype in both surveys and, in 2020, also chronic insomnia. Less TSO was associated with lower happiness and optimism levels and poor health-status. Our findings suggest that TSO may be a protective factor for sleep, mood and health, particularly during stressful and uncertain times.

Collection of smartphone and internet addiction

The enigma of smartphone and internet addiction has plagued academics for the last decade, now scholars believe this behavior might have a substantial effect on human health and social issues. However, there are literature gaps. Thus, BMC Psychiatry works with us to launch the special collection "Smartphone and Internet Addiction".

The association between smartphone use and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia

BACKGROUND

The use of smartphones among the general public and health care practitioners, in particular, is ubiquitous. The aim of this study was to investigate the relationship between smartphone addiction and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia.

METHODS

This cross-sectional study used an online questionnaire to collect data on smartphone addiction, sleep quality, psychological distress, and loneliness as well as demographic information.

RESULTS

A total of 773 health care students and workers participated in the study, with an average age of 25.95 ± 8.35, and 59.6% female participants. The study found a positive significant association between smartphone addiction and psychological distress (F(1,771) = 140.8, P < 0.001) and emotional loneliness (F(1,771) = 26.70, P < 0.001). Additionally, a significant negative association between smartphone addiction and sleep quality was found (F(1,771) = 4.208, P = 0.041). However, there was no significant relationship between smartphone addiction and social loneliness (F (1,771) = 0.544, P < 0.461).

CONCLUSION

These findings suggest that smartphone addiction has a negative impact on psychological distress, sleep quality, and emotional loneliness among health care students and workers. It is important to promote strategies to reduce smartphone dependency in order to avoid the harmful consequences of smartphone addiction.

Changes of Health Outcomes, Healthy Behaviors, Generalized Trust, and Accessibility to Health Promotion Resources in Taiwan Before and During COVID-19 Pandemic: Comparing 2011 and 2021 Taiwan Social Change Survey (TSCS) Cohorts

PURPOSE

The present study compared two nationally representative cohort datasets concerning Taiwan residents' healthy behaviors, subjective health outcomes, generalized trust, and accessibility to health promotion resources.

PATIENTS AND METHODS

The Taiwan Social Change Survey (TSCS) was conducted in two waves ten years apart: 2011 cohort (n = 1021; 48.4% males) and 2021 cohort (n = 1425; 47.4%) cohorts. Descriptive statistics were calculated to compare the two TSCS datasets. Then, multiple regression models were constructed with health outcome as the dependent variable, and demographics and other key components as independent variables.

RESULTS

The 2011 TSCS cohort showed higher prevalence for cigarette smoking (30.8% vs 25.2%; p=0.002), alcohol drinking (52.5% vs 24.3%; p<0.001), exercise habits (52.7% vs 48.0%; p=0.02), and better fruit and vegetable accessibility (Mean=3.91 vs 3.82; p=0.04). The 2021 TSCS cohort reported higher body mass index (Mean=24.20 vs 23.63; p<0.001), less residency in urban areas (22.4% vs 31.1%; p<0.001), better jogging accessibility (4.14 vs 4.05; p=0.006), higher generalized trust (2.26 vs 2.17; p=0.001), and greater internet usage (3.43 vs 2.89; p<0.001). The regression model showed that exercise habits (standardized coefficient=0.20 and 0.10; p<0.001) and generalized trust (standardized coefficient=0.11 and 0.11; p=0.004 and <0.001) were consistently associated with health outcomes in both cohorts. Additionally, internet use (standardized coefficient=-0.07; p=0.026) and alcohol drinking behaviors (standardized coefficient=-0.07; p=0.0022) were negatively associated with health outcomes in the 2021 cohort.

CONCLUSION

The present study demonstrated the trends and changes over 10 years regarding multiple health-related components among Taiwan residents. The study's findings provide insight into education promotion programs to reduce unhealthy behaviors as well as enhancing generalized trust building and developing healthy behaviors for Taiwan residents.

Association between trajectories of problematic mobile phone use and chronotype among Chinese college students

AIMS

This study aimed to describe the prevalence of problematic mobile phone use (PMPU) and chronotype among Chinese college students, estimate PMPU development trajectories, and further examine the effect of PMPU trajectories on chronotype.

DESIGN

In a stratified cluster sampling design, PMPU and chronotype were evaluated in 999 college students from two universities in a 2-year prospective investigation from April 2019 to April 2021, and an investigation was conducted every six months (time 1 ∼ time 5, T1 ∼ T5).

PARTICIPANTS

N = 999 college students (mean age at T1: 18.8 years (SD = 1.2), 37.7% male) took part in the study.

MEASUREMENTS

The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and the Pittsburgh Sleep Quality Index (PSQI) were used to assess the PMPU and sleep quality of college students at each time point. The Morning and Evening Questionnaire (MEQ) was adopted to investigate the chronotype of college students at T5.

FINDINGS

The prevalence of PMPU at T1 ∼ T5 was 24.3%, 27.3%, 35.1%, 31.2% and 31.9%, respectively. The prevalence rates of morning types (M-types), neutral types (N-types), and evening types (E-types) were 19.1%, 70.8%, and 10.1%, respectively. Using latent growth mixture modelling, we identified three trajectories of PMPU: low-level (49.5%), moderate-level (38.6%), and high-level score trajectories (11.9%). Multivariate logistic regression analysis results showed that a trajectory with a high score was positively associated with E-types (P < 0.05). After stratification by gender, a high-level score trajectory was positively associated with E-types only among female college students (P < 0.05). There were sex differences in the association between trajectories of PMPU and chronotype.

CONCLUSION

Long-term symptoms of PMPU may be a potential risk factor for circadian rhythm disturbance among college students, and this effect was significantly different between genders.

Evaluation of two weight stigma scales in Malaysian university students: weight self-stigma questionnaire and perceived weight stigma scale

BACKGROUND

This study aimed to examine the psychometric properties of the Weight Self-Stigma Questionnaire (WSSQ) and Perceived Weight Stigma Scale (PWS) among Malaysian university students.

METHODS

University students who were studying in a Malaysia university with a mean age of 24.0 years (n = 380; females 71.6%) were recruited through convenience sampling between 19 August and 30 September 2021. They completed a Google Form consisting of information on sociodemographic background, weight stigma, psychological distress and self-reported body weight and height. Psychometric testing was conducted using the classical test theory (including confirmatory factor analysis) and Rasch models to confirm the two-factor structure of WSSQ and the unidimensional structure of the PWS using the various fit indices. Concurrent validity of the total scores of WSSQ and PWS with psychological distress and body mass index (BMI) was also investigated. Internal consistency using Cronbach's alpha was conducted.

RESULTS

The confirmatory factor analyses and Rasch analyses verified the two-factor structure for the WSSQ and the single-factor structure for the PWS. Both the WSSQ and PWS showed good internal consistency and good concurrent validity as demonstrated by their significant correlations with psychological distress and BMI.

CONCLUSION

The WSSQ and PWS have strong validity and reliability, and they can both be used to assess weight stigma among Malaysian university students.

LEVEL OF EVIDENCE

V: Descriptive study.

Associations of Problematic Internet Use, Weight-Related Self-Stigma, and Nomophobia with Physical Activity: Findings from Mainland China, Taiwan, and Malaysia

Insufficient physical activity is a common problem for university students because they may engage in sedentary lifestyle owing to excessive time spent on their smartphones and social media use. This may result in problematic internet use (PIU) and nomophobia (fear of not having a mobile phone). Moreover, prior evidence shows that weight-related self-stigma is an important factor contributing to low physical activity. Therefore, the present study examined the associations between PIU, nomophobia, and physical activity among university students across mainland China, Taiwan, and Malaysia. Participants (3135 mainland Chinese, 600 Taiwanese, and 622 Malaysian) completed the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), Nomophobia Questionnaire (NMPQ), Weight Self-Stigma Questionnaire (WSSQ), and International Physical Activity Questionnaire Short Form (IPAQ-SF). The measurement invariance of the assessed questionnaires was supported across the three regions. The present findings analyzed using partial least squares structural equation modeling showed that (i) greater nomophobia was associated with higher levels of physical activity, (ii) greater weight-related self-stigma was associated with higher levels of physical activity, and (iii) greater nomophobia was associated with greater weight-related self-stigma. Although the present findings suggest the possibility that experiencing some level of nomophobia or weight-related self-stigma appears to help improve physical activity, it is not recommended that these be encouraged, but reducing PIU should be targeted as a means to improve physical activity.

Binge-Watching and Mental Health Problems: A Systematic Review and Meta-Analysis

BACKGROUND

Binge-watching, the viewing of online videos or streamed content, may be associated with different types of mental health problems. The present study aimed to investigate the associations between binge-watching and five mental health concerns including depression, loneliness, sleep problems, anxiety, and stress.

METHODS

Academic databases of PubMed, Scopus, Web of Science, ProQuest, PsycINFO, and Psych Articles were systematically searched through February of 2022. The Newcastle-Ottawa Scale was used to assess the methodological quality. A meta-analysis was performed on Fisher's z values as effect sizes, using a random effect model. Publication bias, small study effect, and moderators in this association were assessed.

RESULTS

Binge-watching was significantly associated with the five types of mental health concerns with the most robust correlations found with stress (0.32) and anxiety (0.25). Stronger associations between binge-watching and two types of mental health problems (depression and sleep problems) were found during the COVID-19 pandemic than before the pandemic. Moreover, stronger associations between binge-watching and two types of mental health problems (stress and sleep problems) were found in developing countries than in developed countries.

CONCLUSIONS

The associations between binge-watching and mental health concerns were significant and positive. Programs and interventions to reduce binge-watching should be considered and tested.